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Second Call Fund c/o The Turf Paradise Foundation Finding Second Careers for Retired Racehorses 1501 West Bell Road Phoenix, AZ 85023 602.942.3336 Intake Report
Date: ____________________ Time: __________ Name: ____________________ Age: ___________ per papers____ per vet_____ Sex: ____________________ Breed: ____________________ Color: ____________________ Markings: __________________ Tattoo: ____________________ ___________________________ Registration (if applicable): _______________ Height: ______ (Hands) Arizona Hauling card no: _______________ Weight: ______ (Estimated) Description Date of Injury:______________ Track/Race #_______________________________ Injury Reported:____________________________ Trainer________________________ Observed health of horse: __________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Description of any known injuries: ___________________________________________ ________________________________________________________________________ ________________________________________________________________________ Behavior, disposition, attitude toward children or things we should be aware of: _______ ________________________________________________________________________ ________________________________________________________________________ List of all tack or other donations: ____________________________________________ ________________________________________________________________________ Health History Name of veterinarian: _____________________________________________________ Date of Vaccinations: ______________________________________________________ Name of farrier & date of last trimming: _______________________________________ Name of wormer used & last date of treatment: _________________________________ Date of West Nile Vaccination: ______________________________________________ Donor(s) of Horse: ________________________________________________________ Signature(s) of Donor(s): _____________________________________________ _____________________________________________ Address: ________________________________________________________________ Phone: Home: ____________ Work: ____________ Cell: ____________ Witness: __________________________________ Date: __________________
The Second Call Fund c/o The Turf Paradise Foundation is a registered 501c3 charity.
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